Hafner Michael, Herold Tina R, Kufner Alexander, Asani Ben, Anschütz Andreas, Eckardt Franziska, Priglinger Siegfried G, Schiefelbein Johannes
Department of Ophthalmology, LMU University Hospital, LMU Munich, 80336 Munich, Germany.
J Clin Med. 2025 Apr 3;14(7):2454. doi: 10.3390/jcm14072454.
: Macular edema (ME), due to retinal vein occlusion (RVO), is a major cause of vision impairment. Many patients experience suboptimal responses to anti-vascular endothelial growth factor (anti-VEGF) monotherapy, necessitating alternative treatment approaches. Faricimab, a bispecific antibody targeting VEGF-A and angiopoietin-2 (Ang-2), introduces a novel dual-mechanism therapy. This study evaluates the short-term real-world efficacy of switching to Faricimab in patients with treatment-resistant ME secondary to RVO. : This retrospective study included patients from LMU University Hospital who were switched to Faricimab due to an inadequate response or adverse events related to prior intravitreal therapy (Ranibizumab, Aflibercept, or Ozurdex). All patients completed a structured loading phase of four monthly injections. Key outcome measures included changes in best-corrected visual acuity (BCVA, logMAR), central subfield thickness (CST, µm), and intraretinal fluid (IRF) presence on optical coherence tomography (OCT). Changes were assessed from baseline (mo0) to three months (mo3). The study included 19 eyes from 19 patients (mean age 63.0 ± 14.2 years). BCVA improved from 0.20 logMAR at baseline to 0.00 logMAR at mo3 ( < 0.01). CST decreased from 325 µm to 280 µm ( < 0.01). The proportion of eyes with IRF reduced from 100% to 32% ( < 0.01). Significant reductions in retinal volume within the 1 mm and 6 mm (both < 0.01) circles of the ETDRS grid were observed. : Switching to Faricimab in patients resulted in significant short-term improvements in BCVA, CST, and IRF resolution. Given the small sample size and retrospective design, these findings should be interpreted as exploratory and hypothesis-generating. Further studies are needed to evaluate long-term efficacy and optimal treatment regimens.
黄斑水肿（ME）是视网膜静脉阻塞（RVO）导致视力损害的主要原因。许多患者对抗血管内皮生长因子（抗VEGF）单药治疗反应欠佳，因此需要其他治疗方法。法西单抗是一种靶向血管内皮生长因子A（VEGF-A）和血管生成素-2（Ang-2）的双特异性抗体，引入了一种新型双机制疗法。本研究评估了在继发于RVO的治疗抵抗性ME患者中改用法西单抗的短期真实世界疗效。 这项回顾性研究纳入了因对先前玻璃体内治疗（雷珠单抗、阿柏西普或地塞米松玻璃体内植入剂）反应不足或出现不良事件而改用法西单抗的来自慕尼黑大学医院的患者。所有患者均完成了为期四个月每月一次注射的结构化负荷期。主要结局指标包括最佳矫正视力（BCVA，logMAR）、中心子野厚度（CST，µm）的变化以及光学相干断层扫描（OCT）上视网膜内液（IRF）的存在情况。评估从基线（第0个月）到三个月（第3个月）的变化。 该研究纳入了19例患者的19只眼（平均年龄63.0±14.2岁）。BCVA从基线时的0.20 logMAR改善至第3个月时的0.00 logMAR（P<0.01）。CST从325 µm降至280 µm（P<0.01）。有IRF的眼的比例从100%降至32%（P<0.01）。在ETDRS网格的1 mm和6 mm圆内观察到视网膜体积显著减小（均P<0.01）。 患者改用法西单抗后，BCVA、CST和IRF消退情况在短期内有显著改善。鉴于样本量小且为回顾性设计，这些发现应被视为探索性的且用于生成假设。需要进一步研究来评估长期疗效和最佳治疗方案。
